| NPI | 1316487572 |
|---|---|
| Former Name | MONICA MARIE CARRILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1249600417) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2024-07-05 |